北京市42家社区医院血脂异常防治能力的评价研究

目的了解北京市42家社区医院血脂相关辅助检查和调脂药物的配备情况以及社区医生血脂异常的诊治水平。方法于2003年710月采用面访和问卷调查的方法，访问北京市海淀区和朝阳区42家二级医院和一级医院主管业务的院长、检验科和药房负责人等，了解各医院血脂辅助检杏的条件和药房调脂药物的配备情况，同时采用闭卷考试的方法对42家医院内科系统的632名医生进行了血脂异常临床有关知识及病例诊治水平的问卷调查。结果100％的社区医院可以检查血清总胆固醇和甘油三酯，87．5％和72．5％的医院有他汀类和贝特类调脂药物，100％的医院可以检测谷丙转氨酶和40．0％的医院可以检测血清肌酸激酶。社区医生正确回答血脂异常临床分型的比例为5．2％；为高胆固醇血症病例选择治疗方案的正确率为53．7％，制订降脂目标的正确率为17．6％。结论北京市社区医院的硬件条件基本上可以满足血脂异常防治的需求，要全面开展血脂异常的防治工作亟需提高社区医生的诊治能力。

A study on the capability of dyslipidemia diagnosis and treatment among 42 community hospitals in Beijing

Objective To understand the use of lipidemia related assistant examinations and lipidlowering agents,the clinical ability among physicians in district and community hospitals in Beijing,and to evaluate the capability of dislipidemia diagnosis and treatment in these hospitals. Methods A survey was carried out in 42 hospitals in Chaoyang and Haidian district,including 9 district level hospitals,and the rest were at the community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals. A total number of 632 physicians in those hospitals were investigated,using a close book examination. Results 100% of the hospitals could perform TC and TG tests; 87.5 % and 72.5 % of the hospitals had medications as statins and bile acid,respectively; 100% of the hospitals could test ALT and 40.0% of the hospitals could test CK. The correct rates of selecting treatment strategy and determining the appropriate treatment goals were 53.7% and 17.6%, respectively. Conclusion The hardware condition of community hospitals seem to have satisfied the implicit requirements of dyslipidemia evaluation and treatment but it was essential to improve the knowledge and ability among physicians in community hospitals.